What should I do if my preschooler's vomiting?

Throwing up is usually no cause for alarm. But in some cases it can signal a serious problem. Here's how to tell when your preschooler's vomiting needs immediate medical attention — and how to deal with vomiting that doesn't require a doctor's care.

He has severe abdominal pain. Have your child point to the part of his tummy that hurts. Pain that is centered around the navel and then moves to the lower right side of the abdomen, for example, could signal appendicitis.

His vomit contains bile (a green substance) or blood that resembles dark coffee grounds. The doctor will probably want to see a sample of the vomit if it contains blood or bile, so as distasteful as it is, you should try to save some in a plastic baggie. Green bile can indicate that the intestines are blocked, a condition that needs immediate attention.

He has a swollen, tender abdomen. This could indicate a buildup of fluid or gas, a blocked intestine, a hernia, or some other digestive tract problem. Blockages are uncommon but serious.

He vomits more than once after suffering a head injury, which may indicate a concussion.

The vomit contains blood. A little blood in the vomit is usually nothing to worry about, as the force of vomiting can cause tiny tears in the blood vessels lining the esophagus. Your child's vomit may also be tinged with red if he's swallowed blood from a cut in his mouth or a nosebleed within the last six hours. But call the doctor if your preschooler continues to have blood in his vomit or the amount increases. As mentioned above, if the blood resembles dark coffee grounds, go to the emergency room right away.

He has pain in the upper right side of the abdomen along with fatigue and jaundice (a yellowing of the skin or whites of the eyes). These might signal that your child has hepatitis.

He regularly throws up when exposed to certain people or places. If your child vomits whenever he gets to preschool, for example, it could be a sign of stress. See what his doctor thinks (though you don't need to call her after-hours for this one!).

Call a poison control center if:

You suspect your preschooler has swallowed something toxic. Call the American Association of Poison Control Center's national emergency hotline at (800) 222-1222 or your local poison control center immediately. If you can identify what he's swallowed — for example, you find an empty medicine bottle — tell the medical experts what it is, and they'll give you exact instructions for taking care of your child.

Experts used to tell parents to keep either syrup of ipecac or activated charcoal on hand for poisoning emergencies. But that's no longer the case: Ipecac is not an effective treatment for poisoning — most emergency rooms don't even use it anymore — and activated charcoal hasn't been proven a safe or effective remedy to give children at home.

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